Using the method of in vivo magnetic resonance spectroscopy we examined 17 patients with moderately advanced chronic renal insufficiency, 21 patients with chronic renal failure treated by haemodialysis, and 15 dialyzed patients with symptomatic renal osteopathy. The ratios of intracellular phosphocreatine and inorganic phosphate concentrations of these subjects measured at rest were compared with those found in healthy controls. While we noted significantly lower (p < 0.01) ratio values in all patients, subjects with osteopathy showed a lower value than dialyzed patients free of bone disease. Haemodialysis improved the result of examination in 7 patients. The results can be summarized as follows: (1) patients with altered renal function have significantly impaired energy metabolism of skeletal muscle, and (2) the disorder is more severe in patients with renal osteopathy than in those free of it.
Background: Post-transplant osteopathy is a known complication of kidney transplantation (KTx). The aim of this study was to assess bone mineral density (BMD) in a large cohort of patients with treatment depending on pre-transplant pa-rathormone (PTH) and baseline BMD. Patients and Methods: 347 consecutive KTx recipients (222 M, 125 F) finished all follow-up measurements of BMD at lumbar spine, femur and radius using DEXA Lunar (at baseline and at 6 and 18 months). Results: Bone loss with a T-score below –2.5 affected 37.2% of patients before KTx. A negative correlation between baseline PTH and BMD was found (p < 0.01). Patients with high levels of PTH had more bone loss than patients with low PTH values (p < 0.01). In the lumbar spine, a decline of BMD was found in the first 6 months, and after 18 months an improvement was found in all subgroups (p < 0.001). In femur, significant changes were found only in low-PTH patients after 6 months (p < 0.001); the others did not reach significant results. There was no improvement after 18 months in low-PTH patients. In radius, bone loss was not found. Conclusion: A relationship between differences in progression of BMD after transplantation and PTH level at baseline was found.
Background: Coronary calcium score (CCS) is established as an index for the risk of coronary heart disease (CHD). The aim of this prospective study was to assess changes in CCS in patients 1 year after kidney transplantation (KTx). Method: A total of 221 consecutive renal transplant recipients were enrolled in our prospective study (140 males/81 females). CCS was analyzed by spiral multidetector CT at baseline and 1 year after KTx. Bone mineral density (BMD) was measured in the lumbar spine (L-BMD) and femur (F-BMD). Results: The mean CCS was 539 ± 1,033 at baseline. 33% of the patients had a CCS of 0, and 33% of patients had a CCS of >401. A negative correlation was found between F-BMD and CCS, but no correlation was found between L-BMD and CCS. Using CCS, a positive correlation was found between total cholesterol and the age of patients, but no correlation of CCS was found with other biochemical markers of bone and lipid metabolism. One year after transplantation, the mean CCS was 703 ± 1,253; in 75% of patients the CCS was the same and 25% had a higher CCS. Conclusion: A high risk of CHD was found in 33% of renal graft recipients. No improvement in CCS was found 1 year after KTx.
The main aim of this paper is to study interaction between strontium and metallothionein (MT), and to determine changes in strontium and thiols (MT, reduced glutathione, cysteine, and homocysteine) level in plasma, serum, and urine samples of patients treated with strontium ranelate (SrR). To investigate the interactions between MT and strontium(II) ions, adsorptive transfer stripping technique coupled with differential pulse voltammetry (DPV) the Brdicka reaction was employed. Besides standard Brdicka signals (Co, RS 2 Co, Cat1, Cat2, Cat3), we observed new signal related to Sr-MT interaction. Further we investigated the effect of various time of interaction, concentration of strontium(II) ions and temperature of supporting electrolyte on Brdicka signals. Optimal time of interaction was 240 s. Under temperature of supporting electrolyte 20 8C, we measured linear dependence of Cat3 signal height on strontium(II) ions concentration. After that we have investigated the possibility of strontium-MT interactions, we were interested in strontium, MT and low molecular mass thiols levels in serum and urine of patients treated with strontium(II) ions to cure osteoporosis. Strontium concentration determined by atomic absorption spectrometry was 55 AE 5 mg/L before and 10,500 AE 1,400 mg/L at the 30 th day of SrR administration. Levels of metallothionein in serum ranged from 0.1 to 6.4 mM. Correlation between serum strontium concentration and MT level was determined and correlation coefficient was R ¼ 0.93.
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